Rural Nursing for APRNs: Tips for Practice
Written by:
University of Tulsa
• Jul 13, 2026
For many small towns and rural communities experiencing a shortage of physicians and other health care workers, advanced practice registered nurses (APRNs) who choose to specialize in rural nursing are making a world of difference.
Acting as primary care providers, rural nurses work closely with their patients and create programs and resources that provide health and wellness information to the community. Pursuing an advanced education through a Master of Science in Nursing (MSN) program offers individuals interested in rural nursing the opportunity to build a fulfilling career caring for people in communities that lack quality care.
What Is Rural Nursing?
Rural nursing focuses on providing care to patients who live in remote and geographically or culturally isolated areas. For many of these communities, their location and smaller population can make accessing adequate health care services challenging.
Nationwide, both rural and urban communities are facing a shortage of primary care providers and physicians. The Association of American Medical Colleges (AAMC) projects that by 2036, the United States will face a deficit of up to 86,000 physicians. In rural communities, this shortage can be particularly challenging, as patients may experience long wait times or be forced to travel long distances to access routine care, emergency care, or specialized care. APRNs willing to serve in these rural areas can help address these challenges.
A day in the life of APRNs who choose to work in rural communities can differ from those who work in cities. Often working in smaller care facilities with less advanced equipment and limited staff, nurses may be required to take on additional duties outside their normal responsibilities.
Nursing in rural areas often requires working closely with other health care professionals. This can help promote teamwork and a sense of unity not always found in urban settings.
Health Professional Shortage Areas (HPSA)
The federal government identifies many rural communities as health professional shortage areas (HPSAs). The HPSA designation was created to help combat the lack of health care resources in underserved communities nationwide. People facing health disparities in rural communities often live in designated areas. Communities can be given the HPSA designation for a variety of reasons, each one presenting its own set of challenges.
Medically Underserved Areas (MUAs)
The term medically underserved area refers to geographic areas that are experiencing a shortage of primary care service providers. MUAs can refer to areas of all sizes, from entire countries to civil divisions or individual counties.
Medically Underserved Populations (MUPs)
The term medically underserved area refers to geographic areas that are experiencing a shortage of primary care service providers. MUAs can refer to areas of all sizes, from entire countries to civil divisions or individual counties.
Geographic HPSAs
A geographic HPSA refers to the entire population in an established geographic area that is facing a shortage of or lack of access to health care services.
Population HPSAs
Similar to MUPs, population HPSAs refer to the specific subset within a population that has limited access to services. This includes those lacking access to both primary care services as well as other necessary resources within a specific or established geographic area.
Facility HPSAs
Facility HPSAs fall under the category of either facility HPSAs or automatic facility HPSAs. Facility HPSAs include public and nonprofit medical facilities, mental health institutions, and correctional facilities that do not have adequate access to care services or resources. Automatic facility HPSAs are facilities that are federally or state designated and do not need to apply for an HPSA designation.
Health Disparities in Rural Communities
A multitude of factors cause health disparities in rural communities. From the remoteness of their locations and challenges accessing health care equipment or funding, to shortages of care providers and the lack of informed health care representatives equipped to serve culturally isolated communities, rural residents face a number of difficulties when it comes to maintaining their health.
Benefits and Challenges of Rural Nursing
There are several unique advantages to rural nursing. In remote communities with small population sizes, nurses are more likely to act as primary care providers and have long-term or repeat patients. This allows nurses to build a rapport with their patients, allowing them to care for them and their families throughout their lives and build a sense of community within their practice.
Conversely, rural nursing faces significant challenges. Smaller communities typically have fewer resources, which can lead to rationing available equipment and materials, longer wait times for emergency services, care providers taking on additional responsibilities, and patients needing to travel long distances to access specialized care, all of which can lead to health disparities.
Facilities with staff shortages may require health care workers to take on additional responsibilities. Whether administrative or hands-on, the extra work can take a toll on nurses and lead to feelings of burnout.
Full Practice Authority and Rural Nursing: Why It Matters
As rural communities face shortages of primary care providers and limited resources, administrators and policy professionals are working to mitigate the challenges. Granting APRNs full practice authority is a possible solution that can improve the quality of care in some of the nation’s highest-need areas.
Full practice authority allows APRNs to provide patient care without physician supervision, including diagnosing patient conditions, providing treatment, and prescribing medications. This broader capacity can help APRNs reduce gaps in rural care caused by the ongoing physician shortage.
Granting full practice authority to APRNs can lead to four positive impacts in rural communities:
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Improved Access: Local APRNs can make it far more convenient for rural patients to get the care they need.
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Streamlined Care Delivery: APRNs working independently can care for patients without the delay of waiting for physician approval.
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Reduced Costs: More direct care can reduce visits and ancillary services, which can lower medical costs.
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Increased Choice: Full practice authority can give patients expanded options for whom to see for their care.
In November 2025, Oklahoma passed House Bill 2298, which allows APRNs who meet certain criteria to have full prescriptive authority. This means they will be able to prescribe medications without physician oversight.
With much of rural Oklahoma qualifying as a medically underserved area, due to both low-income populations and geographically isolated populations, the physician and nursing shortages are felt acutely across the state. A rancher in a corner of Oklahoma might need to travel halfway across the state for a simple X-ray or a preventive screening. Granting full practice authority to APRNs can help mitigate these issues.
How to Become a Rural Nurse
The standard for education, certification, and workplace experience required to work in rural nursing can be extensive. In many cases, health care facilities and practices will look to nurses who are certified as advanced practice registered nurses, demonstrating that they are able to work independently and take on additional responsibilities without requiring the supervision of a physician.
APRN Education and Qualifications
Advanced practice registered nurses are highly trained nurses working as nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists. Before becoming an APRN, nurses must have earned a Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN) and passed the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become registered nurses (RNs). The process to become an APRN working in rural nursing can look like this:
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Earn a Bachelor of Science in Nursing or an Associate Degree in Nursing.
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Pass the NCLEX-RN and become an RN.
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Earn a Master of Science in Nursing or Doctor of Nursing Practice; these programs often require students to specialize.
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Gain work experience and complete supervised clinical hours.
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Become board-licensed and certified, as required nationally or by state regulations.
Rural Nursing Career Outlook
Nursing in rural areas can be demanding. However, the long-term job outlook for those who pursue a career in nursing is positive. According to the U.S. Bureau of Labor Statistics (BLS), employment of certain APRNs, including nurse practitioners, is projected to grow by 35% between 2024 and 2034, which is significantly faster than the national average job growth projected for all occupations as well as the 5% growth projected for RNs.
Tips for Rural Nurses
With facilities often required to make do with limited resources or a smaller workforce, rural nursing can be a game of multitasking and problem-solving. Here are some tips to manage rural nursing successfully:
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Make time for self-care: As with any kind of nursing, rural nursing requires treating patients with compassion, patience, and consideration. Doing so can take a lot of energy, making it essential that nurses take the time they need to care for themselves to avoid burnout.
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Work together as a team: Smaller workforces mean that the better staff can work together, and they can provide care more efficiently. By taking the time to build rapport and positive relationships with other members of their health care team, nurses can more effectively coordinate patients’ care in high-pressure situations.
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Continue education and pursue additional certifications or skills: The demands placed on rural nursing teams can be extensive. While nurses have the option to refer patients to other health care professionals, the more services they are qualified to provide, the better they are able to serve their communities.
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Embrace living in a small community: Successful health care outcomes often correlate to patients being willing to follow care directives. Building a relationship with patients in their community can be an opportunity for nurses to build trust with their patients and encourage them to invest in their care.
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Build a network of care professionals: Nursing in rural areas can involve working with limited resources or medical equipment. By building a strong network of care providers with different skill sets, nurses can better direct the care of their patients, streamlining the process and mitigating costs for their patients.
Make a Positive Impact in Your Community as a Rural Nurse
Many rural communities across the country are facing both a lack of access to health care services and a shortage of skilled professionals able to provide them. In many of these communities, APRNs who are qualified to deliver primary care can make a significant difference.
By enrolling in a well-rounded advanced degree program, such as the online Master of Science in Nursing or online Family Nurse Practitioner, Doctor of Nursing Practice (FNP, DNP) programs at The University of Tulsa, individuals interested in rural nursing can prepare themselves with the knowledge and skills they’ll need to act as primary care providers for their patients.
Featuring one-on-one support from accomplished faculty, the opportunity to choose between specialty tracks, and a curriculum that is shaped around current industry needs, the TU MSN and DNP programs were designed to provide you with the tools you need to succeed. Explore how you can make a positive impact in your community as a rural nurse.
Recommended Readings
Jessika Evans’ Story of Transformation at TU: From BSN to MSN
FNP vs. PA: What’s the Difference?
Clinical Leadership in Nursing: How Sarah McAuliff Shapes the Next Generation of Nurse Leaders
Sources:
American Association of Colleges of Nursing, Nursing Shortage Fact Sheet
American Association of Nurse Practitioners, State Practice Environment
American Nurses Association, Advanced Practice Registered Nurse (APRN)
Indeed, “How to Become an Advanced Practice Registered Nurse (APRN)”
Oklahoma Board of Nursing, Independent Prescriptive Authority Frequently Asked Questions
OpusVi, What’s It Like to Be a Nurse in Rural Healthcare
U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
